Occupational TherapistNHS

Job summary

Enable is one of four national DWP funded pilots testing a new approach to fit notes and is the most clinical of the four. It runs across Barrow and Mid Furness Primary Care Networks, delivered by MBPCC under an NHS contract.

For participating practices, all fit notes are issued by the Enable service rather than by the GP practice. There is no change to fit note legislation, so every patient still needs a valid, signed fit note. The pilot then offers eligible patients registered at a pilot practice, in work, and agreeing to share data with the DWP a workability assessment and plan. Employers are contacted only with the patients explicit agreement.

The service expects to handle more than 20,000 fit note requests a year at full rollout.

The service uses EMIS, AccuRx, X on Surgery Connect and Florey questionnaires.

Main duties of the job

To provide occupational therapy assessment and intervention for working age adults whose health is affecting their ability to stay in or return to work, as part of the Enable service.

• Carry out functional and work focused assessments with patients from pilot GP practices who request a fit note.
• Issue and sign fit notes as the certifying healthcare professional.
• Complete workability assessments and plans with eligible patients, setting practical, occupation focused goals to support a sustainable return to work.
• Work as part of a multidisciplinary team with the Advanced Nurse Practitioner, Occupational Health Nurses and admin team.
• Record activity and outcomes accurately so the pilot can supply data and learning to the Department for Work and Pensions.

Job description

Fit note certification

• Assess patients fitness for work and issue and sign fit notes in your own name, as permitted for HCPC registered occupational therapists under the Social Security, Medical Evidence and Statutory Sick Pay, Medical Evidence, Amendment Regulations 2022.
• Assess the patient, by face to face, video or telephone consultation or by reviewing a written report from another healthcare professional, before issuing a fit note
• Certify only within your own scope of practice and competence. Refer to the ANP or Clinical Lead when the presenting condition, complexity or risk falls outside it.
• Issue fit notes through EMIS, including correct dates, condition wording and review periods.
• Meet the service turnaround standard for fit note requests, currently 3 working days.
• Take part in audit of your fit notes for quality and consistency, and act on feedback from the Clinical Lead.

Clinical assessment and workability plans

• Manage a defined caseload of working age adults referred through the fit note pathway.
• Complete workability assessments and plans with eligible patients assessing physical, cognitive, psychological and environmental factors affecting work
• Advise on graded return to work, activity pacing, fatigue and symptom management, and practical workplace adjustments.
• With the patients explicit agreement, liaise with employers about reasonable adjustments and return-to-work arrangements.
• Signpost and refer to other services and community resources.
• Identify and act on risk, including mental health risk, escalating promptly to the Clinical Lead and Advanced Nurse Practitioner.

Communication and teamwork

• Communicate complex and sometimes sensitive information about health and work, adapting to each patients needs and overcoming barriers to understanding.
• Work as an active member of the Enable multidisciplinary team and attend team meetings, case discussions and huddles.
• Build good working relationships with pilot GP practices, PCN teams and partner organisations.
• Contribute an occupational therapy perspective to the development of pathways, templates and patient information.

Records, data and evaluation

• Keep accurate, contemporaneous clinical records in EMIS to professional and MBPCC standards.
• Record activity and outcome data accurately and on time, as needed for DWP evaluation.
• Contribute to service evaluation, audit and quality improvement, including sharing learning from the pilot.

Professional development

• Take part in annual appraisal and agree a personal development plan.
• Maintain a CPD portfolio that meets HCPC requirements.
• Develop knowledge of vocational rehabilitation, occupational health and work and health policy.

Key Working Relationships

Internal

• Service Lead day to day management, absence and sickness, appraisals
• Clinical Lead clinical accountability
• Advanced Nurse Practitioner day to day clinical management
• Clinical colleagues within Enable, allied health professionals, administrative

External

• Referring GPs, practice managers and primary care teams across Barrow and Mid Furness.
• Patients and, with consent, their employers, line managers, HR and occupational health providers.
• Secondary care, therapy, mental health and musculoskeletal services; Jobcentre Plus; local employers; VCFSE partners and other statutory agencies.

WORKING ARRANGEMENTS

• This is a fixed term post for 12 months, funded through the national pilot. Continuation beyond the pilot period cannot be guaranteed and is subject to national decisions on the future of the model.
• A flexible and agile approach to working is expected. The service operates a blended model of face to face clinics, remote consultation and home working, and the balance between these will vary with service demand and patient need.
• Home working is supported for remote assessment, report writing, supervision and administrative activity, subject to a suitable, confidential home working environment and compliance with information governance requirements. Home working is an operational arrangement, not a contractual entitlement, and does not remove the requirement to attend sites.
• Regular travel across Barrow and Mid Furness is required. Access to a vehicle and a full UK driving licence, or an equivalent means of meeting the travel requirements of the post, is necessary.
• Some flexibility over working hours may be needed to accommodate patients who are in work and employers who are only available outside core hours such as Saturday working.
• The post holder will be expected to work in a rapidly evolving service where processes, systems and documentation change during the pilot period, and to lead others through that change.

General responsibilities

• Professional standards: Work within the HCPC Standards of Conduct, Performance and Ethics and the RCOT Professional Standards and Code of Ethics. Maintain HCPC registration; any lapse must be reported immediately and stops fit note certification.
• Information governance: Keep all patient and service information confidential in line with UK GDPR, the Data Protection Act 2018, the Caldicott Principles and MBPCC policy. Share data with the DWP only as set out in the Enable privacy notice and the patients agreement.
• Safeguarding: Follow safeguarding adults and children procedures and complete the training required for the role before commencement of job
• Health and safety: Follow health and safety and lone working policies, and report incidents and near misses promptly.
• Infection prevention and control: Follow infection prevention and control policies.
• Equality and diversity: Treat everyone with dignity and respect, and act in line with MBPCCs equality policies.
• Mandatory training: Complete all statutory and mandatory training on time.
• Flexibility: This job description is not exhaustive. It may change as the pilot develops, by agreement with the post holder.

About us

Morecambe Bay Primary Care Collaborative is the largest employer of Primary Care colleagues in South Cumbria, we are a not-for-profit Community Interest Company, and work to support, guide and underpin primary medical care across Lancashire and South Cumbria.

We deeply value education and learning, hosting the Lancashire and South Cumbria Training Hub. We have a great team on our board that guide our organisation, and you will be supported to excel in your role.